Cyber-Physical Systems Week Registration Form 1. Please put an X next to the appropriate registration type: by 3/31/08 4/1/08 on ___ IEEE/ACM member (conference only) $620.00 $750.00 ___ IEEE/ACM member (workshops only) $225.00 $275.00 ___ IEEE/ACM member (conference+workshops) $845.00 $1,025.00 ___ non-member (conference only) $775.00 $940.00 ___ non-member (workshops only) $275.00 $350.00 ___ non-member (conference+workshops) $1050.00 $1,290.00 ___ IEEE/ACM member student (conference only) $360.00 $440.00 ___ IEEE/ACM member student (workshops only) $175.00 $225.00 ___ IEEE/ACM member student (conference+workshops) $535.00 $665.00 ___ non-member student (conference only) $460.00 $550.00 ___ non-member student (workshops only) $225.00 $275.00 ___ non-member student (conference+workshops) $685.00 $825.00 2. If your registration includes conference attendance, please put an X next to the conference you would like to designate as your home conference: ___ HSCC ___ IPSN ___ RTAS 3. If your registration includes workshop attendance, please put an X next to the workshop you would like to designate as your home workshop: ___ International Workshop on Mobile Device and Urban Sensing (MODUS) ___ Workshop: From Embedded Systems to Cyber-Physical Systems ___ The 2nd Workshop on Event-Based Semantics ___ Workshop on Adaptive and Reconfigurable Embedded System (APRES) 4. If you are registering as a student, please complete the following: Advisor's name: Advisor's e-mail address: 5. If you are an ACM or IEEE member, please complete the following: Membership number: Membership type (ACM or IEEE): 6. If you would like to pay extra page charges for an RTAS paper, please indicate how many pages you would like to pay for: RTAS pages (maximum 2 per paper, $100 each): 7. If you would like to purchase addditional tickets for the conference banquet, please indicate you many you wish to pay for: Extra banquet tickets ($100 each): 8. Please complete the following information: Email address: Prefix (Dr., Prof. etc.): First Name: Middle Name: Last Name: Suffix: Title: Name as it would appear on a badge: Affiliation (University/Company/Organization): Address Line 1: Address Line 2: City: US State/Canadian Province: Int'l State/County/Province (Non US/Canada): Zip (Postal Code): Country: Phone: Fax: Cell Phone: 9. If you have any dietary restrictions, please indicate those here: